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Bone allografting: an original method for biological osteosynthesis and bone reinforcement in children with osteogenesis imperfecta

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Abstract

Purpose

Osteogenesis imperfecta (OI) is a genetic disorder responsible for various symptoms including deformities and frequent fractures. Bone allografting is poorly documented in this condition. The objective of this study was to describe our experience and assessments in a consecutive series of OI patients.

Methods

Thirty-nine lower limb allograft procedures (28 femurs, 11 tibias) were performed in 26OI patients (mean age, 12.9 years). They were classified as type III of Sillence (17), type IV (6), and 3 recessive forms. The indications for surgery were correction of deformity (19), fracture (16), and non-union (4). In all cases, bone allografting was added to reinforce areas of fragility and in 28 cases for osteosynthesis to lock the rotations at the osteotomy site and to avoid screwed metallic plate. The duration of bone consolidation and allograft fusion was assessed. Complications and Gillette functional score were reported.

Results

The mean follow-up was 6.7years (range, 2 to 10 years). On average, bone consolidation was achieved after 3.3 months and graft fusion after 7.7 months. No bone allograft-related complications were observed and there was any secondary displacement. The Gillette functional score was improved in 23 patients and stable in three cases. Complications were reported in two cases: one partial allograft resorption and one delayed consolidation of a non-union. One refracture was observed but after a significant trauma in a child who had regained significant physical activity.

Conclusions

Bone allografting in children with OI is a reliable method of biological fixation, allowing efficient fusion and contributing to increased bone capital and functional outcome.

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Data availability

All data are available on request from the corresponding author and transmitted as an anonymized Excel file.

Code availability

Not applicable.

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Authors and Affiliations

  1. Department of Pediatric Orthopaedics Surgery, Necker Hospital, Assistance Publique Hopitaux de Paris, Université Paris-Cité, 149 rue de Sèvres, 75015, Paris, France

    Mathilde Gaume, Sarah El Yahiaouni, Marine De Tienda, Stéphanie Pannier, Georges Finidori & Zagorka Pejin

  2. Department of Pediatric Genetics, Necker Hospital, Assistance Publique Hopitaux de Paris, Université Paris-Cité, Paris, France

    Genevieve Baujat & Valérie Cormier-Daire

  3. Department of Orthopaedics Surgery, Cochin Hospital, Assistance Publique Hopitaux de Paris, Université Paris-Cité, Paris, France

    Valérie Dumaine

Authors
  1. Mathilde Gaume
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  2. Sarah El Yahiaouni
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  3. Marine De Tienda
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  4. Genevieve Baujat
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  8. Georges Finidori
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Contributions

Mathilde Gaume: literature research, clinical studies, data analysis, statistical analysis, manuscript preparation, manuscript editing; Sarah El Yahiaouni: literature research, data analysis, manuscript preparation; Marine De Tienda: clinical studies, manuscript editing; Genevieve Baujat: clinical studies, manuscript editing; Valérie Cormier-Daire: manuscript editing; Valérie Dumaine: manuscript editing; Stéphanie Pannier: manuscript editing; Georges Finidori: guarantor of integrity of the entire study, study concepts and design, clinical studies, manuscript editing; Zagorka Pejin: guarantor of integrity of the entire study, study concepts and design, clinical studies, manuscript editing.

Corresponding author

Correspondence to Mathilde Gaume.

Ethics declarations

Ethical approval

The Ethics Committee of our institution approved this study (IRB registration: #00011928).

Informed consent

All parents or legal guardians provided their informed consent.

Consent to participate

All patients consented to participate.

Consent to publish

All authors consent to publish the present study in case of acceptance.

Conflict of interest

The authors declare no competing interests.

Guarantor

The scientific guarantor of this publication is Dr Mathilde GAUME.

Statistics and biometry

One of the authors has significant statistical expertise.

Study subjects or cohorts overlap

None of the study subjects or cohorts have been previously reported.

Methodology

Retrospective and performed at one institution.

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Gaume, M., El Yahiaouni, S., De Tienda, M. et al. Bone allografting: an original method for biological osteosynthesis and bone reinforcement in children with osteogenesis imperfecta. International Orthopaedics (SICOT) 47, 1863–1869 (2023). https://doi.org/10.1007/s00264-023-05818-6

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